AccountId: 011433970860
ContactId: 19688021-885e-499c-b669-c6d6885e60bd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 363809 ms
Total Talk Time (AGENT): 102740 ms
Total Talk Time (CUSTOMER): 209673 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/19688021-885e-499c-b669-c6d6885e60bd_20250513T18:37_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is speaking. May I help you?
[CUSTOMER][NEUTRAL] Hi, sweetie. I need your help. Um, we have, uh, we had, let me give you my policy number.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's 02510727.
[AGENT][NEUTRAL] OK, thank you and your name is?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 6762.
[AGENT][NEUTRAL] Thank you. And Ms. [PII], uh, verify your mailing address for me, please.
[CUSTOMER][NEUTRAL] [PII], sorry.
[AGENT][POSITIVE] No, you're fine. And how may I assist you today?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][NEUTRAL] No, you're fine.
[CUSTOMER][NEUTRAL] I'm sorry. Um, the reason I'm calling is
[CUSTOMER][NEUTRAL] Um, I had surgery and back in
[CUSTOMER][NEGATIVE] Like [PII] and then I had another 1 [PII] and we would have had APL and I did call and you guys said that you never got the bill and so I called the hospital and I told them that and they said they would bill so um I gave them all the information and they said that they called and you and you know somebody there said we never had coverage.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] I'm like, oops, yeah, I know we did.
[AGENT][NEUTRAL] And what was that latest, uh, service again? I'm sorry, Ms. [PII].
[CUSTOMER][NEUTRAL] One is it's
[CUSTOMER][NEUTRAL] Um, [PII] it's for Piedmont Fayette Hospital.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For 66,000.
[AGENT][NEUTRAL] OK, and I show that you were active at the time of service. And do you have a callback number by chance in case the call drops?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and let's see.
[AGENT][NEUTRAL] Uh, yes, uh, it shows we received that claim and looks like, uh, benefits were paid to the provider.
[CUSTOMER][NEUTRAL] So on [PII] for 66,000 there was a 5000 applied to deductible and a $3000 for co-pay and did you guys did receive it and you did pay it?
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] We paid 3000 and with that payment it matched your benefit for that data service.
[CUSTOMER][NEUTRAL] OK, so that one's been paid the 3000. OK. What about the date? It says [PII].
[AGENT][NEUTRAL] [PII], let's see.
[CUSTOMER][NEUTRAL] Oh, I needed to to ask you the date that you paid that because they're saying they never got it figures.
[AGENT][POSITIVE] Bless it. Yes, ma'am, I can definitely get that to you. And you said the other one was 1112 of 24?
[CUSTOMER][NEUTRAL] Yes, 139,000.
[CUSTOMER][NEUTRAL] And there was a $3000 member co-pay.
[AGENT][NEGATIVE] Uh huh, don't show that we received that one.
[CUSTOMER][NEGATIVE] And that's the one she said, oh no, we called there and they said you never had insurance. I'm like, I do have insurance because I'm looking at a bill from the, I said I am, I told her I go, I'm really looking at the bill from Georgia bone and Joint which 2 days after my surgery and um they got paid.
[CUSTOMER][NEUTRAL] So, so you're doing, they're doing something wrong. Did you, did you get it, so they said they, did you get anything from Piedmont Noonan Hospital on, for the date of [PII]?
[AGENT][NEUTRAL] Uh, no, ma'am. We hadn't received any claims for that day. No, ma'am.
[CUSTOMER][NEUTRAL] Did you get anything from? Nothing.
[CUSTOMER][NEUTRAL] OK, and could you tell me the date for Piedmont Fayet that [PII]? What date did you pay the 3000?
[AGENT][NEUTRAL] Uh, that was paid on [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] 04 18 [PII]. So see she billed when I told her that they're with the same hospital situation and she's telling and she, I told her she billed it she got paid. There's something wrong with Noonan.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] OK, is there by chance, if I go into this hospital and I get a copy of this, is there a place for me to send it directly myself?
[AGENT][NEUTRAL] You can
[CUSTOMER][NEUTRAL] Do I send it to the [PII]?
[AGENT][NEUTRAL] Um, uh, you will have to mail it or fax it to us. Uh, we would need the billing and the primary EOB.
[CUSTOMER][NEUTRAL] OK. What is that fax number?
[AGENT][NEUTRAL] Uh, yes, ma'am. It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. I'm probably gonna just have to go to that hospital because they do not sound like they're willing to work at this point with me about trying to get that done. And then there were, there were 3 bills and they're from a uh [PII], there were two, and it's from Piedmont Anesthesia Associates. Did you get a bill from them?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Uh, let me see.
[AGENT][NEUTRAL] For anesthesia? No, ma'am. The only claim we've received for that day was just from the facility.
[CUSTOMER][POSITIVE] Do not say it. OK. OK. Well, you've been a big help. I really do appreciate it so much and you have a blessed day.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Alright you too and thank you so much for calling APL bye Miss [PII].
[CUSTOMER][NEUTRAL] Mhm. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.